Most Relevant Information
Provider Data
| NPI Number: | 1003478181 |
| Provider Name: | JACKSON DAVID CLOUSE |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 12254 |
Most Important Dates
| Enumeration Date: | 06/28/2019 |
| Last Updated: | 06/28/2019 |
Provider Practice Location
2060 RHINO CROSSING
MILAN
TN
38358
Practice Location Phone/Fax
| Phone: | 7316132214 |
| Fax: |
Provider Mailing Location
PO BOX 1004
MILAN
TN
383581004
Provider Mailing Phone/Fax
| Phone: | 7316132214 |
| Fax: |